The Influence of the Instructional Approach on Acquiring Clinical Skills in Surgery: A Comparative Effectiveness Study

Ruesseler, Miriam; Tomczak, Mairen; Thrun, Monika; Pfau, Sebastian; Marzi, Ingo; Sterz, Jasmina

doi:10.1016/j.jsurg.2018.07.008

Cited by 14 publications

(17 citation statements)

References 29 publications

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“…When looking closer at the results of this study, it is noticeable that the performance differences and effect sizes between the study-and the control group were greater for the performance of an SFE compared to the insertion of a Bellocq's tamponade. This difference can be explained with the higher level of difficulty of the SFE compared to the Bellocq's tamponade (Supplements 1 and 2) since previous studies found a clear benefit of Peyton's '4-step Approach' for very challenging motor skills, such as laparoscopic suturing and knot tying [15] or the replacement of a complex wound dressing or performing a simple interrupted suture [21]. For relatively easy to learn motor skills like performing external chest compressions or the placement of a laryngeal tube, no significant advantages could be found for Peyton's '4-step Approach' in previous studies Münster 2016).…”

Section: Discussionmentioning

confidence: 99%

“…Especially in a curricular setting with a high number of students and frequently changing trainers, the use of videos enables a higher standardization of the demonstration of the skills. The implementation of standardized instructional videos into Peyton's '4-step Approach' has been investigated in previous studies [11,21,35]. Schwerdtfeger et al compared Peyton's traditional '4-step Approach' with a videobased '4-step Approach' that replaced Steps 1 and 2 with instructional videos to teach acute clinical care of trauma patients to 313 medical students.…”

Section: Discussionmentioning

confidence: 99%

“…A possible way to reduce material and personal recourses is to modify the '4-step Approach' by implementing standardized educational videos [21]. Previous studies have demonstrated that replacing steps 1 and 2 through standardized educational videos does not have any negative effects on the learning outcomes compared to other teaching methods [12].…”

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confidence: 99%

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Comparing video-based versions of Halsted’s ‘See One, Do One’ and Peyton’s ‘4-step Approach’ for teaching surgical skills: a randomized controlled trial

Seifert

Schnurr

Stefanescu

et al. 2020

Preprint

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Background: Teaching complex motor skills at a high level remains a challenge in medical education. Established methods often involve large amounts of teaching time and material. The implementation of standardized videos in those methods might help save resources. In this study, video-based versions of Peyton’s ‘4-step Approach’ and Halsted’s ‘See One, Do One’ are compared. We hypothesized that the video-based ‘4-step Approach’ would be more effective in learning procedural skills than the ‘See One, Do One Approach’. Methods: One-hundred-two naïve students were trained to perform a structured facial examination and a Bellocq’s tamponade with either Halsted’s (n = 57) or Peyton’s (n = 45) method within a curricular course. Steps 1 (Halsted) and 1-3 (Peyton) were replaced by standardized teaching videos. The performance was measured directly (T1) and 8 weeks (T2) after the intervention by blinded examiners using validated checklists. An item-analysis was also carried out. Results: At T1, performance scores significantly differed in favor of the video-based ‘4-step Approach’ (p < 0.01) for both skills. No differences were found at T2 (p < 0.362). The item-analysis revealed that Peyton’s method was significantly more effective in the complex subparts of both skills. Conclusions: The modified video-based version of Peyton’s ‘4-step Approach’ is the preferred method for teaching especially complex motor skills in a large curricular scale. Furthermore, an effective way to utilize Peyton’s method in a group setting could be demonstrated. Further studies have to investigate the long-term learning retention of this method in a formative setting.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparing video-based versions of Halsted’s ‘See One, Do One’ and Peyton’s ‘4-step Approach’ for teaching surgical skills: a randomized controlled trial

Seifert

Schnurr

Stefanescu

et al. 2020

Preprint

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“…A broad range of trained procedures has been identified. For example, basic surgical skills (Ruesseler et al, 2019), spine mobilisations (Gradl-Dietsch et al, 2016;Rossettini et al, 2017), musculoskeletal ultrasound (Gradl-Dietsch et al, 2019) or cardiopulmonary resuscitation (Jenko, Frangež & Manohin, 2012) were used as procedures. Several modified versions of Peyton's teaching approaches were used in the experimental groups.…”

Section: Included Studiesmentioning

confidence: 99%

The effectiveness of the Peyton’s 4-step teaching approach on skill acquisition of procedures in health professions education: A systematic review and meta-analysis with integrated meta-regression

Giacomino

Caliesch

Sattelmayer

2020

PeerJ

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Background Acquisition of procedures is an important element in health professions education. Traditionally procedures are taught using a “see one - do one” approach. That is a teacher demonstrates and describes a procedure and afterwards the students practice the procedure. A more recent teaching approach for the acquisition of procedural skills was presented by Walker and Peyton. Peyton’s teaching approach is a stepwise teaching approach and consists of the following four steps: demonstration, deconstruction, comprehension and performance. The aims of this study were (i) to systematically evaluate the effectiveness of Peyton’s 4–step teaching approach on the acquisition of procedural skills in health professions education and (ii) to evaluate whether studies with fewer students per teacher showed a larger between group difference than studies with more students per teacher. Methods We searched in Medline, PsycInfo, Embase and ERIC for eligible studies. Records were screened by two independent reviewers. A random effects meta-analysis was performed to evaluate skill acquisition and time needed to perform the procedures at post-acquisition and retention tests. A meta-regression was used to explore the effect of the number of students per teacher on the estimated effect of the educational interventions. Results An effect size of 0.45 SMD (95% CI [0.15; 0.75]) at post-acquisition and 0.7 SMD (95% CI [−0.09; 1.49]) at retention testing were in favour of Peyton’s teaching approach for skill acquisition. The groups using Peyton’s teaching approach needed considerably less time to perform the procedure at post-acquisition (SMD: −0.8; 95% [CI −2.13 to 1.62]) and retention (SMD: −2.65; 95% CI [−7.77 to 2.47]) testing. The effectiveness of Peyton’s teaching approach was less clear in subgroup analyses using peer teachers. Meta-regression showed that the number of students per teacher was an important moderator variable. Conclusion Peyton’s teaching approach is an effective teaching approach for skill acquisition of procedural skills in health professions education. When peer students or student tutors are used as teachers the effectiveness of Peyton’s teaching approach is less clear. Peyton’s teaching approach is more effective when small groups with few students per teacher are used.

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“…Krautter et al identified Step 3 as the most crucial part of Peyton's '4-step Approach', contributing significantly more to the learning success than the previous steps due to its inherent combination of motor imaginary [18] and skill performance [16]. However, the method is relatively time-and material-consuming and personnel-intensive, and several other studies have shown that simple procedural skills can also be taught with a considerably reduced didactic effort [19,20], which raises the question of how and for which procedural skill, in particular, Peyton's '4-step Approach' should be used. For example, Orde et al could show that Peyton's '4-step Approach' is not superior compared to the 'See One, Do One' approach in learning how to place a laryngeal mask.…”

mentioning

confidence: 99%

Comparing video-based versions of Halsted’s ‘See One, Do One’ and Peyton’s ‘4-step Approach’ for teaching surgical skills: a randomized controlled trial

Seifert

Schnurr

Stefanescu

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Teaching complex motor skills at a high level remains a challenge in medical education. Established methods often involve large amounts of teaching time and material. The implementation of standardized videos in those methods might help save resources. In this study, video-based versions of Peyton’s ‘4-step Approach’ and Halsted’s ‘See One, Do One’ are compared. We hypothesized that the video-based ‘4-step Approach’ would be more effective in learning procedural skills than the ‘See One, Do One Approach’. Methods: One-hundred-two naïve students were trained to perform a structured facial examination and a Bellocq’s tamponade with either Halsted’s (n = 57) or Peyton’s (n = 45) method within a curricular course. Steps 1 (Halsted) and 1-3 (Peyton) were replaced by standardized teaching videos. The performance was measured directly (T1) and 8 weeks (T2) after the intervention by blinded examiners using structured checklists. An item-analysis was also carried out. Results: At T1, performance scores significantly differed in favor of the video-based ‘4-step Approach’ (p < 0.01) for both skills. No differences were found at T2 (p < 0.362). The item-analysis revealed that Peyton’s method was significantly more effective in the complex subparts of both skills. Conclusions: The modified video-based version of Peyton’s ‘4-step Approach’ is the preferred method for teaching especially complex motor skills in a large curricular scale. Furthermore, an effective way to utilize Peyton’s method in a group setting could be demonstrated. Further studies have to investigate the long-term learning retention of this method in a formative setting.

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The Influence of the Instructional Approach on Acquiring Clinical Skills in Surgery: A Comparative Effectiveness Study

Cited by 14 publications

References 29 publications

Comparing video-based versions of Halsted’s ‘See One, Do One’ and Peyton’s ‘4-step Approach’ for teaching surgical skills: a randomized controlled trial

Comparing video-based versions of Halsted’s ‘See One, Do One’ and Peyton’s ‘4-step Approach’ for teaching surgical skills: a randomized controlled trial

The effectiveness of the Peyton’s 4-step teaching approach on skill acquisition of procedures in health professions education: A systematic review and meta-analysis with integrated meta-regression

Comparing video-based versions of Halsted’s ‘See One, Do One’ and Peyton’s ‘4-step Approach’ for teaching surgical skills: a randomized controlled trial

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